Nursing home deaths: Police investigate inmate death at hospital owned by same doctor

Medical staff at the Memorial Regional Hospital in Hollywood, Florida described the scene as patients from a nearby nursing home arrived in the early morning hours after eight patients died days after Hurricane Irma. (Sept. 14)
AP

Healthcare workers walk down the street near Memorial Regional Hospital in Hollywood, Fla., after five residents at a Florida nursing home that lost power during Hurricane Irma died after a loss of air conditioning during the outage, Broward County officials said Wednesday. Police Chief Tomas Sanchez said another 115 patients were evacuated, including several in critical condition. His office immediately started a criminal investigation, but Sanchez did not indicate specifically what the office was looking for.
"We're not ruling anything out," he said.
The victims were found inside the Rehabilitation Center at Hollywood Hills and the Larkin Community Hospital, which sit in a medical complex surrounded by a larger children's hospital.(Photo11: Jack Gruber, USA TODAY)

Authorities are investigating the death of a federal detainee who tried to kill himself last month inside a Miami hospital owned by the physician who runs a Hollywood nursing home where 12 residents died after Hurricane Irma.

Osvadis Montesino-Cabrera, a 37-year-old Cuban national, died at Larkin Community Hospital on Sept. 1, a week after he was found hanging from a bathroom inside his hospital room, according to U.S. Immigration and Customs Enforcement.

The hospital has been cited in past state and federal inspection reports for failure to monitor patients adequately and placing patients with known psychiatric conditions in unsecured areas because they admitted more than the hospital's license allowed.

Larkin is owned by Dr. Jack Michel, whose Hollywood nursing home is the focus of a separate criminal investigation after 12 people died in the days following Irma. Elderly residents of the Rehabilitation Center at Hollywood Hills remained in sweltering heat after the storm knocked out power and air conditioning, resulting in the death of eight patients on Sept. 13 and four others later.

Efforts to reach Michel this week failed. Larkin lawyer Julie W. Allison declined to comment on the inmate death investigation.

“We can neither confirm nor deny matters that are under the purview of the federal government,” Allison said.

Florida health officials have suspended Michel's license to run the Hollywood nursing home and are taking steps to shut down a second home for the elderly that he owns, the Floridian Gardens Assisted Living Facility in Miami.

Lawyers for Michel's nursing and assisted living homes have said they will fight the state actions. They have argued the nursing home staff followed an emergency plan approved by Broward County officials, and they said Gov. Rick Scott and other state officials ignored their pleas to help restore power at the nursing home.

Scott has fired back, arguing the owners and staff never contacted 911 to report elderly residents in distress. And he said medical professionals at the facilities who argue leaving messages on his cell phone is a substitute for calling 911 "should not be allowed to have any access to patients."

But Scott's administration has given Michel's Larkin Community Hospital access to Florida prisoners under a subcontractor agreement with another health provider approved by the state and through direct contracts with the state.

Larkin has received $48 million in state money over the past decade to provide hospital services. Larkin also received nearly $47 million in federal contracts since 2002 to care for prisoners, including ICE detainees, records show.

ICE detained Montesino-Cabrera in June following his arrest and transfer from U.S. Customs and Border Protection in San Antonio, Texas. A federal immigration judge ordered his deportation on Aug. 17 and he was awaiting removal to Cuba when he sought medical treatment days later, according to an ICE news release.

He was admitted into Larkin on Aug. 22 from the Krome Service Processing Center in Miami, where the medical staff diagnosed him with urinary retention, or the inability to empty his bladder, according to ICE and an autopsy completed by Miami-Dade County's medical examiner.

Montesino-Cabrera, while under supervision of ICE officers, went into his hospital bathroom on Aug. 25 to take a shower, according to the ICE report.

"When staff did not hear water begin running after several minutes, ICE personnel entered the shower area and discovered a self-inflicted strangulation attempt," according to ICE's statement on the death.

Larkin's medical staff resuscitated Montesino-Cabrera and transferred him to the intensive care unit, where he was placed on life support.

"Despite round-the-clock care, Mr. Montesino-Cabrera never regained consciousness and he subsequently died" a week later, according to the ICE statement.

Montesino-Cabrera's death is characterized as a suicide in the autopsy report.

"This investigation remains an open and actively investigated criminal case," said Jennifer Capote, a spokeswoman with the Miami-Dade Police Department.

Scott spokesman McKinley Lewis said the death of a federal detainee raised no concerns for the care Larkin provides state prisoners.

“The safety and well being of federal inmates” is up to federal officials, Lewis said.

A spokeswoman for Florida's Department of Corrections declined to answer how the federal detainee's death reflects on the care state prisoners receive at Larkin. Instead, spokeswoman Michelle Glady said state corrections officials are "not notified when patients at hospitals, who are not state inmates, pass away.”

Larkin operates under a subcontractor agreement approved by state corrections officials with Centurion Managed Care, which is responsible for all medical services provided to state prisoners. Centurion Chief Executive Officer Steven H. Wheeler said earlier this week Larkin's contract is under review.

“Centurion makes the health and safety of those we employ and serve our No. 1 priority and we appreciate you reaching out to us so we may clarify that this inquiry relating to a federal inmate doesn't pertain to us,” Centurion spokeswoman Sarah Bascom wrote in an email.

Larkin has received several citations for violations by state and federal regulators for its treatment of psychiatric patients. In 2010, state regulators cited the hospital for admitting too many psychiatric patients beyond what it was licensed to handle, which led to some patients being placed in unsecured areas.

Federal inspectors found the same problem in 2011, when Larkin was cited for placing psychiatric patients in a surgical unit because there were too many admitted into the hospital. The surgical unit was not secured properly to admit patients with psychiatric conditions and the patients were not properly supervised, according to the inspection.

Others were kept on a floor where patients who may be suicidal were kept in rooms deemed as unsafe, according to the inspection report. Four of the rooms had items such as coiled electric cords for TVs hanging from the walls.

A Larkin administrator told a state inspector he allowed the number of mental health patients to exceed the hospital's limit because it is the only facility in the area that accepts patients requiring an involuntary mental examination under state law known as the Baker Act.

"He stated it was a decision he made and that he believed it was going to be temporary in nature," the report states.

Most recently, the facility was cited in October 2016 for not properly discharging a patient who had been repeatedly readmitted for psychiatric issues. A doctor had determined the man should be released to an assisted living facility on a voluntary basis.

However, observations made by hospital staff showed the man required more rigorous supervision to make sure he takes his medication, according to the state inspection report.

The man was discharged but ran away from the van taking him to the assisted living facility, which was not identified in the report. He called his brother, who called the police to take him back to Larkin, the report states.

In a July 2016 state inspection, the report notes a psychiatric patient was discharged to an assisted living facility that was not licensed to provide mental health care. The facility is not named in the report. The patient was returned to Larkin for observation, the report states.

In that same case, a state inspector noted the guardian for the patient had not provided a signature for the treatment plan.

CLOSE

A search warrant has been granted for a Florida nursing home where eight patients died after Hurricane Irma as investigators continue their criminal investigation into the incident. (Sept. 14)
AP